Literature Review

Does assisted living provide assistance and promote living?Health Affairs; by Sheryl Zimmerman, Robyn Stone, Paula Carder, Kali Thomas; 5/24Assisted living has promised assistance and quality of living to older adults for more than eighty years. ... As assisted living has evolved, the needs of residents have become more challenging; staffing shortages have worsened; regulations have become complex; the need for consumer support, education, and advocacy has grown; and financing and accessibility have become insufficient. Together, these factors have limited the extent to which today’s assisted living adequately provides assistance and promotes living, with negative consequences for aging in place and well-being. This Commentary provides recommendations in four areas to help assisted living meet its promise: workforce; regulations and government; consumer needs and roles; and financing and accessibility. Policies that may be helpful include those that would increase staffing and boost wages and training; establish staffing standards with appropriate skill mix; promulgate state regulations that enable greater use of third-party services; encourage uniform data reporting; provide funds supporting family involvement; make community disclosure statements more accessible; and offer owners and operators incentives to facilitate access for consumers with fewer resources. Attention to these and other recommendations may help assisted living live up to its name.Publisher's note: Many of these ALF recommendations may be helpful in hospice, too...

In praise of hospiceJAMA; by James R. Nicholas, MD; 4/24... Joan did what she wanted to do: she, with the help of hospice, made her dying as easy as possible for me and our children. I have the same wish for myself. I doubt if I will achieve it as well as did Joan, but I will have her as a guide. And I hope I will have the kind of hospice team that Joan had.

[Honoring Nurses Week] Too many nurses are being assaulted. Some say they are being blamed for the attacks. Chief Healthcare Executive; by Ron Southwick; 5/9/24 With disturbing regularity, nurses in hospitals and other healthcare settings are being physically assaulted and verbally harassed. More than half of emergency nurses say they’ve been assaulted or threatened within the past 30 days, according to the Emergency Nurses Association. In a separate study, researchers found that healthcare workers faced at least one violent or aggressive incident for every 40 hours worked, according to findings published by The Joint Commission Journal on Quality and Patient Safety. With the observance of National Nursing Week, the increased violence in healthcare can’t be ignored. Nursing leaders say the regular exposure to violence or threatening behavior is one factor adding to stress and burnout of nurses and, in some cases, spurring them to seek new jobs.

Meet the death doulas who bring comfort to people at the end of their lives Fortune Well; by Liz Seegert; 5/7/24... “The essence of doula care is to provide non-judgmental support and guidance to individuals and families through times of critical, transformative life change,” according to the National End of Life Doula Alliance (NEDA), a member-based nonprofit that offers trainings and directories. Their role complements that of other services, such as hospice or palliative care, with physical, emotional, spiritual, and practical support. That can include holding someone’s hand or listening as a patient reminisces, or simply being a calming presence during the dying process. On the practical side, a doula might help the patient draft advance directives or family members with tasks like care coordination, vigil planning, respite care, and bereavement support. 

Executive Personnel Changes - 5/10/24

Financial strain on nursing homes sparks buying binge Modern Healthcare; by Diane Eastabrook; 5/8/24Skilled nursing facility deals increased more than 80% in the first quarter of 2024 compared with the same period in 2023. There were 57 nursing home acquisitions valued at nearly $1.4 billion in the first quarter of this year compared with 31 deals valued at $448 million during the same period last year, according to Levin Associates, which tracks healthcare mergers and acquisitions. ... Last year was the worst year for healthcare bankruptcies in five years, according to restructuring and consulting firm Gibbins Advisors. Senior living and pharmaceuticals accounted for half of the 79 Chapter 11 filings in healthcare in 2023, the company said. It predicted continued distress for the senior care industry this year in a January research report.

“I wonder if my first breath was as soul-stirring to my mother as her last breath was to me.” -  Lisa Goich-Andreadis, 14 Days: A Mother, A Daughter, A Two-Week GoodbyeEditor's Note: Remembering my mom, Jane.

2024 Hastings Center Cunniff-Dixon Physician Awards announcedThe Hastings Center email; 5/9/24The Hastings Center and The Cunniff-Dixon Foundation are pleased to announce six recipients of awards that honor physicians for providing exemplary care to patients nearing the end of life. The awards are based on technical competence, personal integrity, empathic dialogue with patients, active engagement with the family and loved ones, practical and heartfelt communication regarding advance directives, and compassionate alleviation of suffering. Congratulations:

Other Business Headlines of Interest, updated 5/9/24 per nasdaq.com

New dementia guide provides best Standards of Care from 100+ not-for-profit hospice, palliative and advanced illness organizations PR Newswire; by National Partnership for Healthcare and Hospice Innovation (NPHI); 5/9/24 The National Partnership for Healthcare and Hospice Innovation (NPHI), the national voice for not-for-profit hospice care, in collaboration with Aliviado Health and the Center to Advance Palliative Care (CAPC), announces today the release of the NPHI "Dementia Care Resources Provider Guide." The new guide aims to improve the quality of life for patients with dementia, reducing hospitalizations, and easing the burden of advanced illness for families and caregivers. A dementia diagnosis poses substantial challenges for both patients and their families, impacting millions of Americans nationwide. Shockingly, the Alzheimer's Association reports that an estimated 6.7 million individuals in the U.S. currently live with dementia. 

Paris in spring, Bali in winter. How ‘bucket lists’ help cancer patients handle life and death The Conversation; by Vivan Lam; 5/8/24 In the 2007 film The Bucket List Jack Nicholson and Morgan Freeman play two main characters who respond to their terminal cancer diagnoses by rejecting experimental treatment. Instead, they go on a range of energetic, overseas escapades. Since then, the term “bucket list” – a list of experiences or achievements to complete before you “kick the bucket” or die – has become common. ... But there is a more serious side to the idea behind bucket lists. One of the key forms of suffering at the end of life is regret for things left unsaid or undone. So bucket lists can serve as a form of insurance against this potential regret. The bucket-list search for adventure, memories and meaning takes on a life of its own with a diagnosis of life-limiting illness. Editor's Note: Health acuity (especially for hospice patients), finances, and other practical factors can prevent acutalization of the person's bucket list wishes. Yes, fulfilling items can happen! And when not possible (perhaps the most common response), the clinician's sensitive presence, validation of the person's hope, and gentle exploration of why it matters can bring relevant, meaningful support. Involving family members (with the patient's permission) can inspire other generations to fulfill the person's wish, bringing new purpose to mourning and grief-restoration processes ahead.

It’s ‘unbelievable’ Walmart couldn’t figure out how to operate primary care clinics profitably, expert saysHealthcare Brew; by Maia Anderson; 5/7/24Walmart’s decision to shutter its Walmart Health initiative at the end of April left some healthcare industry experts wondering: If Walmart—the largest company in the world by revenue—can’t profitably operate primary care clinics, who can? Given the retailer’s enormous scale, it’s more likely Walmart simply decided to focus on more profitable aspects of healthcare, one expert told Healthcare Brew.

The Check-Up: How seniors can better take care of their mental health The Keene Sentinel; by Olivia Belanger Sentinel Staff; 5/8/24 My generation talks about mental health a lot. In our late 20s, my friends and I routinely check in to see how we’re feeling, reschedule plans because we’re in a mental funk or talk about how we can help support each other when we’re not feeling mentally healthy. ... But I know that for older generations, this can be hard to come by. ... [Older] adults are more likely to experience life changes — like coping with a serious illness or losing a loved one — which can lead to feelings of grief, social isolation or loneliness, according to the National Institute of Mental Health (NIMH). Loneliness in particular is one of the biggest threats to seniors, especially those who live in rural areas like the Monadnock Region where reliable transportation is limited. Research shows loneliness is as bad for people’s health as smoking 15 cigarettes per day, according to the U.S. Surgeon General. Signs that you may need to help your mental health, NIMH says, include: ...